ASH 2022: Short-course Brentuximab Vedotin with Chemotherapy is Highly Active in Early-Stage Bulky Hodgkin LymphomaASH 2022

Treatment with short-course brentuximab vedotin (Adcetris; BV), an antibody-drug conjugate, combined with chemotherapy in early-stage, bulky Hodgkin lymphoma (HL) was associated with four-year overall and progression-free survival (PFS) rates over 90%, according to extended follow-up results.

The research team, which included LRF Scientific Advisory Board member and Immediate Past Chair Andrew D. Zelenetz, MD, PhD of Memorial Sloan Kettering Cancer Center, presented updated results from a study that was initially published in 2021. Alison Moskowitz, MD of Memorial Sloan Kettering Cancer Center, another contributing author, serves as a faculty member for LRF’s Lymphoma Scientific Research Mentoring Program (LSRMP). The study included 116 patients with untreated, bulky HL who were given four courses of BV plus chemotherapy (doxorubicin, vinblastine, and dacarbazine; AVD). Patients were divided into four groups, and after initial BV+AVD treatment, they received various levels of consolidative radiation therapy, including none.

Across all groups, the four-year overall survival rate was 93%, and the PFS rate was 98%. The PFS rate did not vary significantly based on how much radiation therapy was received (90 to 96% for all groups).

The researchers also evaluated whether metabolic tumor volume (MTV) or positron emission tomography (PET)-2 results at baseline were predictive of response to treatment. Among patients with high and low MTV, the four-year PFS rate was 91% and 100%, respectively. Differences in PFS were greater in patients stratified by PET2 (79% in the PET2-positive and 95% in the PET2-negative groups). When both measures were combined, the strongest predictor of poor response to therapy was high MTV/PET2-positive disease, with a four-year PFS rate of 60%; PFS was 95% in the MTV-low/PET2-positive group, and 100% in both PET2-negative groups, regardless of MTV status.

The researchers concluded that short-course BV-AV in early-stage bulky HL, with or without consolidation radiation therapy, remains highly active and well tolerated at four years, though people with high baseline MTV and PET2 positivity may be at greater risk for treatment failure.

This study also included contributions from LRF grantees Connie Lee Batlevi, MD, PhD of Memorial Sloan Kettering Cancer Center; Carla Casulo, MD of University of Rochester Medical Center; Niloufer Khan, MD of Memorial Sloan Kettering Cancer Center; Anita Kumar, MD of Memorial Sloan Kettering Cancer Center; and M. Lia Palomba, MD of Memorial Sloan Kettering Cancer Center; LRF SAB members Ranjana Advani, MD of Stanford University School of Medicine; Jonathan Friedberg, MD, MMSc of the University of Rochester Medical Center; and Steven Horwitz, MD of Memorial Sloan Kettering Cancer Center; LRF SAB member and Past-Chair, Andrew D. Zelenetz, MD, PhD of Memorial Sloan Kettering Cancer Center; LRF Mantle Cell Lymphoma Consortium (MCLC) member Elizabeth Budde, MD of City of Hope; New York Lymphoma Rounds Steering Committee member David Straus, MD of Memorial Sloan Kettering Cancer Center; and past Scientific Advisory Board (SAB) member Craig Moskowitz, MD University of Miami Health System.